A COMPARATIVE STUDY OF THE EFFECT OF COMMUNITY CARE SYSTEM IN THE AGED SOCIETY BETWEEN JAPAN AND BRITAIN

即使在20世纪80年代，由于日本对居家老年人的政策指导坚持非正式护理，社会护理服务也没有系统化，英国的社会护理服务体系在20世纪70年代以后得到了发展，但也存在一些问题。报告中指出的重要结果如下。在日本，许多社会工作者、护理工作者、健康访问者和老年病学家都关注对体弱老人的“个案管理”或“护理管理”，但是，只有少数人在他们的护理站或机构进行了尝试，没有地方政府的支持。这些情况与北美或英国的做法大不相同。我们特别指出，个案经理只协调一些服务，如家庭帮助和日托服务。最近与日本的“公共护理保险”计划相关，强调美国护理模式的评估和护理计划理念，对于居家老年人，尤其是社区长期护理来说，它们是不合适和不够的。应该需要通过生活模式来发展思想。英国1990年的社区照顾改革引入了由地方政府负责的照顾管理服务，不仅针对老年人，而且针对所有需要社会支持的居民。这似乎是相当有价值的长期护理在社区，但是，我们需要继续随访更多年，以准确地评估。最令人关注的是新的公共服务系统，分为服务购买者和提供者两部分。一些社会工作者评论说，如果他们只是作为服务提供者帮助人们，他们对自己作为合格社会工作者的角色和任务感到失望。这将成为欧洲福利国家社会工作实践中的新问题。

Even during 1980's, as japanese polecy guidanace for the elderly at home insisted to informal care, social care services have not systematized and British system of it have developed after 1970's, however it also have some problems. The important results which pointed out in the report are as next.a. In japan, many social worker, care worker, health visitor and gerontlogist have concern about "case management" or "care managenent" for frail elderly, however, only few have tried at their care station or agencies, without supports by Local government.b. Those cases are quite different compare with North American or British practices. We especially pointed out that case manager only coodinated some services, as like home help and day care services.c. Recently related to Japanese plan of "Public Insurance for Care", the idea of assesment and care plan by American nursing model is emphasized, they are not appropriate and enough for elderly at home, especially for long term care in community. It should be needed to develope idea by life model.d. British reform of community care in 1990 introduced care management service by responsivility of Local government, for not only elderly but all residents who needed any social supports. It seems fairly valuable for long term care in the community, however, we need to continue follow up more years to evaluat precisely.e. Most concern is about the new system of public services, devided in two division of purchaser and provider of services. Some social workers comment that they had disappointed about their role and task as qualified social worker, if they only helped people as service provid2r. this commets will become new problems among social work practice in europien welfare countries.